放射性肝纤维化过程的定量研究

经＾６０Ｃｏγ线照射大鼠肝区，通过光镜、电镜和图像分析仪、宣研究了照后１年肝脏的病理改变。结果表明，３０Ｇｙ组在照射后１年内逐渐发生了放射性肝纤维化病变。在肝纤维化发生过程中，肝细胞内糖原颗凿含量进行性减少，间质中胶原纤维含量进行性增加，网状纤维于照射１－３个月呈进行性增加。     

甲珠消囊汤治疗卵巢囊肿20例

笔者自2001年以来，用自拟甲珠消囊汤治疗卵巢囊肿20例，疗效满意，现报告如下。     

坏宜性脓皮病12例临床分析

报告12例疸性腔皮病患者的性别与年龄构成、并发症、实验室检查、治疗经过和结果，对该病的病因、治疗和预后进行了讨论。     

鼻内窥镜下鼻中隔矫正术

目的 :研究鼻内窥镜下鼻中隔矫正术的优点。方法 :鼻内窥镜下鼻中隔矫正术 5 0例 ,同期施行传统的鼻中隔矫正术 5 0例作为对照 ,分析两者手术时间、术中出血量及疼痛情况。结果 :鼻内窥镜组治愈率为96% ,手术时间 ( 35 .5 0± 5 .2 0 ) min,术中出血量 ( 2 3.2 2± 4.2 5 ) ml,疼痛发生率为 1 6% ;传统手术组治愈率为 90 % ,手术时间 ( 4 5 .64± 6.34) min,术中出血量 ( 31 .34± 5 .64) ml,疼痛发生率为 38%。经统计学分析两组治愈率差异无显著性 ( P>0 .0 5 ) ,鼻内窥镜组手术时间明显缩短 ( P<0 .0 1 ) ,术中出血量明显减少 ( P<0 .0 5 ) ,术中疼痛发生率明显降低 ( P<0 .0 5 )。结论 :鼻内窥镜下鼻中隔矫正术照明好 ,术野清晰 ,直视下手术 ,易剥离粘连处和及时发现粘膜损伤 ,手术时间短 ,术中出血量少 ,疼痛轻 ,术后并发症少 ,特别是鼻中隔矫正同期完成功能性鼻内窥镜手术及歪鼻矫正手术时更显示其优越性     

保留肾单位手术治疗早期小肾癌21例临床分析

OBJECTIVE: To evaluate the clinical effects of nephron-sparing surgery in patients with early-stage small renal cell carcinoma. METHODS: Nephron-sparing surgery was performed in 21 patients with renal cell carcinoma including 1 with solitary kidney, 3 with unilateral tumor and contralateral renal compromise, and 17 with unilateral tumor and normal contralateral kidney. The diameter of the tumors ranged from 1.5 to 6.0 cm, with a mean of 2.8 cm. The tumor diameter in 17 patients with normal contralateral kidney was less than 4 cm (mean 2.5 cm) and the average diameter in 4 patients with contralateral renal compromise was 4.2 cm. Sixteen cases were in stage T(1), 4 in stage T(2), and 1 in stage T(3). Of the 21 patients, 4 underwent tumor enucleation, 10 polar nephrectomy and 7 wedge resection. RESULTS: All patients were followed up for an average of 40.8 months (7 to 66 months). One patient suffered a right lung and mediastinum metastasis 3 years after the surgery later and 1 with chronic glomerulonephritis required dialysis 27 months after the operation. No surgical complication or local recurrence were found in other patients. CONCLUSION: As a safe and effective therapy for early-stage small renal cell carcinoma, nephron-sparing surgery can be considered as the gold-standard therapy for patients with lesions less than 4 cm in T(1) and T(2) stages of localized unilateral tumor with normal contralateral kidney.     

激励机制在成人高校部门考核管理中的应用

我院是一所独立设置的成人医学高等学校.为促进学院整体工作的改革与发展,提高学院办学的社会效益和经济效益,提高教学质量,使学院各项工作更加科学化、规范化,2000年开始,根据学院工作重点和各部门工作的实际情况,我校实行了部门工作年度考核评估.在评估考核工作中,注重采用了激励措施,有效地提高了学院整体工作水平和管理干部的质量意识,取得了较好的实效.现介绍如下.……     

Just-in-Time Evidence-Based E-mail “Reminders” in Home Health Care: Impact on Patient Outcomes

OBJECTIVE: To assess the impact and cost-effectiveness of two information-based provider reminder interventions designed to improve self-care management and outcomes of heart failure (HF) patients. DATA SOURCES/STUDY SETTING: Interview and agency administrative data on 628 home care patients with a primary diagnosis of HF. STUDY DESIGN: Patients were treated by nurses randomly assigned to usual care or one of two intervention groups. The basic intervention was an e-mail to the patient's nurse highlighting six HF-specific clinical recommendations. The augmented intervention supplemented the initial nurse reminder with additional clinician and patient resources. DATA COLLECTION: Patient interviews were conducted 45 days post admission to measure self-management behaviors, HF-specific outcomes (Kansas City Cardiomyopathy Questionnaire-KCCQ), health-related quality of life (EuroQoL), and service use. PRINCIPAL FINDINGS: Both interventions improved the mean KCCQ summary score (15.3 and 12.9 percent, respectively) relative to usual care (p< or =.05). The basic intervention also yielded a higher EuroQoL score relative to usual care (p< or =.05). In addition, the interventions had a positive impact on medication knowledge, diet, and weight monitoring. The basic intervention was more cost-effective than the augmented intervention in improving clinical outcomes. CONCLUSIONS: This study demonstrates the positive impact of targeting evidence-based computer reminders to home health nurses to improve patient self-care behaviors, knowledge, and clinical outcomes. It also advances the field's limited understanding of the cost-effectiveness of selected strategies for translating research into practice.